191596628-11-1-2019-33-CC-AALN-BHHNF6-20191101102502

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191596628
Report Date: 11/01/2019
Date Signed: 11/01/2019 10:25:07 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	DELAYO FAMILY DAY CARE		FACILITY NUMBER:	191596628
ADMINISTRATOR:	DELAYO, MARTHA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 814-9009
CITY:	BALDWIN PARK	STATE: CA	ZIP CODE:	91706
CAPACITY:	14	CENSUS: 2	DATE:	11/01/2019
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Martha Delayo		TIME COMPLETED:	10:40 AM

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A RANDOM INSPECTION CONDUCTED IN SPANISH

Licensing Program Analyst, Ariel Cazares conducted an unannounced annual random site inspection to the facility. Upon arrival, LPA met with Licensee Martha Delayo and toured the facility. There were 2 children present. Individuals residing in the home are the licensee and spouse. Licensee’s operating hours are Monday-Friday 6am-6pm.

The home is a one story, 3-Bed, 2-Bath home. The following areas are used for day-care: Daycare room in the rear of the home, 1 bathroom, kitchenette, and backyard. Off limit areas include: The front of the home which includes 3 bedrooms (which are latched), 1 bathroom, living room, and kitchen.

LPA observed the required postings on a parent board in the daycare room. There are age appropriate toys, books, and games. LPA did not observe any exposed electrical outlets. The fire extinguisher located in the kitchen was purchased on 4/29/19 and charged. There is an operational smoke detector and carbon monoxide in the daycare, which was tested by LPA and found to be operational. Per Licensee, there are no firearms present on the premises.

LPA inspected the backyard which children used for outdoor activity. The age-appropriate toys and play equipment for the children. There are bird cages with birds in the backyard. There are no pools or spas, or other bodies of water observed.

Children’s roster and files were reviewed. Staff files were reviewed. Licensee’s First Aid/CPR certificates are valid through 05/2021. Licensee's disaster drill log notes last drill conducted on 8/12/19. Licensee has a working telephone.

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Ariel Almazan	TELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: DELAYO FAMILY DAY CARE	FACILITY NUMBER: 191596628
	VISIT DATE: 11/01/2019

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The following were discussed: Individuals who are 18 years of age or older living in the home must be finger print cleared prior to being in the presence of the children in care. Individuals within one month of their 18th birthday must be fingerprinted immediately. No smoking, No infant walkers, No baby bouncers, No Johnny jumpers, No exersaucers and any other item that falls into that category. LPA discussed disaster drills, posting requirements, children records requirements, mandated child abuse and injury/death reporting.

LPA reviewed SIDs, Never Shake A Baby, and safe sleeping practices. Infants should sleep mouth up, on their backs, free of clutter surrounding their sleeping space. To access forms and regulations on line visit: www.ccld.ca.gov. Mandated reporter training must be completed every 2 years. www.mandatedreporterca.com (currently not available in licensee's primary language).

Incidental Medical Services (IMS) policy was discussed. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

A qualified Assistant must be present and actively involved in caring for children whenever nine (9) or more children are present at the facility in a large family child care home.

No Deficiencies were cited on this visit.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Licensee Martha Delayo. A copy of this report and appeal rights were provided and explained.

*Due to printer error a handwritten copy of the report was provided.*

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Ariel Almazan	TELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2019

LIC809 (FAS) - (06/04)

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